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[Evaluation of Low Concentration Dithiothreitol for Negating the Monoclonal Anti-CD38 Interference with Transfusion
Jie Song1, Ying-Hui Chen Li1, Ai-Ping Liu1
1Department of Blood Transfusion, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi
|August 18, 2022
Summary
Low concentration dithiothreitol (DTT) effectively removes interference from monoclonal anti-CD38 in transfusion compatibility testing. This method is safe and preserves the detection of most clinically significant alloantibodies, ensuring effective red blood cell transfusions.
Area of Science:
- Transfusion Medicine
- Immunohaematology
- Biochemistry
Background:
- Monoclonal anti-CD38 antibodies can interfere with standard transfusion compatibility testing.
- Accurate compatibility testing is crucial for preventing transfusion reactions.
Purpose of the Study:
- To evaluate the efficacy and safety of low concentration dithiothreitol (DTT) in mitigating anti-CD38 interference.
- To establish a clinical strategy for transfusion compatibility testing in the presence of anti-CD38.
Main Methods:
- Standard blood typing, direct antiglobulin testing (DAT), and antibody screening were performed.
- Red blood cells and serum were treated with varying concentrations of DTT (0.005-0.2 mol/L).
- Antibody screening and cross-matching were conducted using anti-human globulin cards post-DTT treatment.
Main Results:
- 0.01 mol/L DTT at 37°C for 30 minutes effectively eliminated anti-CD38 interference in antibody screening and cross-matching.
- This DTT concentration maintained the detection of clinically relevant alloantibodies (e.g., anti-K, anti-e).
- Ten patients receiving transfusions showed no acute or delayed hemolytic reactions, indicating effective red blood cell transfusions.
Conclusions:
- Low concentration DTT (0.01 mol/L) is a safe and effective agent for resolving anti-CD38 interference in compatibility testing.
- This method preserves the sensitivity for detecting most clinically significant alloantibodies.
- The findings support the development of improved clinical transfusion strategies.
